Abstract P4-05-04: Health-Related Quality of Life and Work Impairment Among Individuals Living with HER2+ Breast Cancer with Brain Metastases
Authors: Victoria G. Morris, Alexandra K. Zaleta, Heather Badt
Journal: Cancer Research (2023)

Abstract Background: Roughly 20% of people diagnosed with breast cancer (BC) will be considered HER2+. HER2+ BC patients are among those at highest risk for developing brain metastases, with up to 50% developing brain metastases. Brain metastases are associated with faster disease progression, shorter survival, and myriad increased impairments. Despite the significant burden faced by HER2+ BC patients living with brain metastases (BMBC), there is little empirical research available regarding the unique experiences of this population. The goals of this exploratory study were to examine the feasibility of recruiting HER2+ BMBC patients to complete an online survey, and to describe their health-related quality of life (HRQOL) and experiences with work impairment. Methods: 62 women with HER2+ metastatic BC were recruited via advocacy partners, Living Beyond Breast Cancer and Metastatic Breast Cancer Alliance, and completed an online survey in January 2022. Participants reported sociodemographics, clinical history, current caregiving support received, physical health (Patient-Reported Outcomes Measurement Information System (PROMIS) Global Physical Health 2av1.2), HRQOL (PROMIS-29v2.0 and PROMIS Cognitive Function Short Form 8a) and work impairment (Work Productivity and Activity Impairment Questionnaire–Specific Health Problem (WPAI-SHPv2.0)). Descriptive statistics were calculated for study variables; PROMIS measures were converted to T scores (M=50, SD=10), enabling comparisons to established population benchmarks. Results presented in this study are restricted to the 30 HER2+ participants living with BMBC. Results: Participants were 47% White, 23% Hispanic, 23% Asian, 3% Black/African American, 3% American Indian/Alaska Native; mean age=43y (range: 33-72); 83% held a Bachelor degree or higher; 70% were married or partnered; mean years since BMBC diagnosis=2.7 (range: &amp;lt; 1-20); mean years between diagnosis and onset of metastatic disease=1.8 (range: 0-11). 67% of participants reported receiving constant care from a caregiver; the remaining participants reported receiving an average of 10.2 hours/week of care. 50% of participants reported physical health corresponding to poor levels (&amp;gt;2 SD on PROMIS). The majority of participants reported HRQOL impairments corresponding to moderate to severe levels (&amp;gt;1SD on PROMIS): Anxiety (84%); Physical Function (80%); Pain Interference (77%); Depression (70%); Fatigue (70%); Sleep Disturbance (67%); Cognitive Function (63%); and Ability to Participate in Social Roles and Activities (53%). Mean symptom burden T-scores (range: 60.4-67.7) and mean functional impairment T-scores (range: 36.0-39.9) were poorer relative to several reference groups (i.e., other women with HER2+ MBC, overall BC population benchmarks, general US population benchmarks). At the time of the survey, 73% of participants were not employed due to disability. Among those employed (n=7); 100% reported that BMBC negatively affected their employment in the past week: mean percent of scheduled work hours missed=37% (range: 14-74%); mean percent of reduced productivity while working=39% (range: 0-80%); and mean overall work impairment=60% (range: 39-95%). Conclusions: HER2+ BMBC patients experience substantial emotional, physical, social, and cognitive quality of life impairments, high work absenteeism, reduced productivity, and overall work impairment, suggesting significant unmet needs for this population. Efforts to recruit HER2+ BMBC patients were successful, suggesting high feasibility of future work with a more robust sample. Despite the small sample size, our descriptive results provide a key foundation for future research with HER2+ BMBC patients to formally test hypotheses and evaluate predictor variables impacting patient HRQOL and work impairment. Citation Format: Victoria G. Morris, Alexandra K. Zaleta, Heather Badt. Health-Related Quality of Life and Work Impairment Among Individuals Living with HER2+ Breast Cancer with Brain Metastases [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P4-05-04.